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The hospitalist will see you now

A little-known program at two Grand Junction hospitals is resulting in some good paybacks.

St. Mary’s Hospital and Community Hospital each run hospitalist programs. That means a medical doctor is always on site to handle inpatient care for those patients who do not have a primary care provider, for patients traveling and who have primary care doctors too far away to make it to the hospital or for those patients whose primary care physicians have contracted with the hospital for the program.

“What we’re seeing is our patients’ (health-care needs) are getting more and more complex,” said Dan Prinster, vice president of business development at St. Mary’s. “We’re trying to keep hospital stays down to keep costs down. Hospitalists work right from the get-go until patients are transferred out of the hospital.”

Anyone needing hospital care can be admitted only by a doctor. For years, that duty meant on-call doctors would admit patients or the hospital would call the patient’s primary care doctor to come in and admit a patient. On-call doctors at St. Mary’s, for example, were being overwhelmed with the numbers of patients entering the Emergency Room who didn’t have primary care physicians.

Hospitalists can take on the duties of admitting patients and following up with their care through their stay.

“They have the ability to see a patient multiple times a day,” said Dr. Gaither Bynum, director of St. Mary’s hospitalist program. “The feedback from nurses is they like a having a doctor in the hospital 24 hours a day.”

St. Mary’s has eight full-time and part-time hospitalists, and Community’s program is expected to grow to four hospitalist positions.

Hospitalists only do inpatient care. They work in shifts, which can be attractive for some doctors because primary care physicians essentially work two jobs: days seeing patients at their offices and nights doing rounds at hospitals. Hospitalists generally are trained in internal medicine, but their backgrounds can vary. The positions are some of the most highly recruited in the nation, Prinster said.

Studies have shown that hospitalist programs can save health care dollars, Bynum said. On-site doctors potentially can release a patient from the hospital sooner than a primary care doctor, who may only have the chance once a day to check on a hospitalized patient.

Hospitalists can order tests and act immediately on the results of those tests in the hospital setting.

Unlike policies in some hospitals, local primary care doctors still make rounds for their hospitalized patients.

“Some hospitals have gone to the point of only having a hospitalist program. We think that’s a mistake,” Prinster said.

Hospitalists cannot become a primary care doctor for a patient.

Having a hospitalist program can help a hospital function more efficiently because doctors can more closely see the working relationships among departments, Bynum said. The program also helps to maintain a collaborative effort with other health care workers in the community.

Because of a local shortage of primary care physicians, some doctors are taking extra clients. At some point, it becomes difficult for doctors to work in their offices during the daytime and work nights at a hospital.

“One of our roles is to bolster primary care as much as possible,” Bynum said. “One of the things that hospitalists can do is let us take some of the burden off.”